Study of Acute upper limb ischemia cases in

Abstract

For most surgeons, experience with upper limb ischemia is limited so that the guidelines for successful management are less clear than are those for lower limb ischemia. Accordingly, it's essential that each patient be carefully assessed even if the presentation appears only to be mildly symptomatic because severe ischemia suddenly supervene and an optimal chance for successful treatment will have been lost (KenneJh A Mayers. 1997)

50 patients presented to the vascular surgery department, Assiut University

Hospital in the one year period of the study with the mean age of 45.5 years.

The upper extremities are subjected to a variety of unique intrinsic arterial disorders. Etiologies encountered in current study were; embolic ischemia, trauma, acute thrombosis, accidental intra-arterial drug injection, T.O.S, subclavian aneurysms, arterial spasm, steal phenomenon complicating created AVF, axillary crutch injury. Acute embolic ischemia, in patients with cardiac disorders were, the commonest among all other causes presented to the study (48%).

Patients were categorized into: acute partial (62%), acute total (28%) and acute neglected ischemia (10%). 12 patients presented in a time interval of less than 12 hours in cases of acute total ischemia.

The plan of treatment and so the outcome were basically affected by the etiology encountered and the category of presentation. Seventeen patients (34%) had been benefited from conservative while 28 patients (56%) had been subjected to surgical treatment and followed by the medical care. In only 5 patients (10%), medical treatment was initiated but surgical interference was needed later in the course of their follow up.